As assessment of the Competition Commission Report and subsequent outcomes

Following the Office of Fair Trading's review of the British deregulated bus market as a whole in 2009, the issues raised were referred to the Competition Commission. Its final report was published in December 2011. Subsequently, the House of Commons Transport Committee carried out an enquiry into the Commission's report, and reactions to it by the operating industry, user groups, and other bodies, which was published in September 2012. A number of major issues have been raised, including the extent to which price competition may be effective, the appropriate rate of return on capital that would be expected within the industry (and appropriate actions where this is excessive in practice), and industry structure. The importance of competition per se, as distinct from attributes of direct concern to users (such as reliability, frequency, and fares) has also been debated. This paper reviews the issues raised, and outcomes to date, in the light of further evidence on the industry's performance. It is demonstrated similar rates of return could be attained through very different operating strategies, which in turn have very different implications for changes in consumer surplus. The alternative uses made of such profits (for example through reinvestment) may also have markedly different impacts effects on users. Rather than focussing on the dangers of excessive rates of return on capital, the outcomes for service users should be the main issue.

James Sacré, a writing of life gesture

In French contemporary poetry, some poets have wished to return to —and so to increase the value of— the enunciation of the poetic subject. In such poetic scenario, the poet James Sacré exemplifies a new approach that tries to re-establish contact with the expression of the poetic subject, albeit always avoiding the pitfalls of excessive ornamentation and poetic effusiveness. Based on the use of simple language, this approach attaches value to legibility and does not hesitate to tap into the most banal or dullest aspects of reality. This article studies one of the procedures used by the poet to reestablish the expression of the poetic subject. This procedure seeks to rewrite life gestures—a technique that evinces an unavoidable relationship between life and poetic words in the work of James Sacré.

The prognostic impact of clinical and molecular features in hairy cell leukaemia variant and splenic marginal zone lymphoma.

Hairy cell leukaemia variant (HCL-variant) and splenic marginal zone lymphoma (SMZL) are disorders with overlapping features. We investigated the prognostic impact in these disorders of clinical and molecular features including IGH VDJ rearrangements, IGHV gene usage and TP 53 mutations. Clinical and laboratory data were collected before therapy from 35 HCL-variant and 68 SMZL cases. End-points were the need for treatment and overall survival. 97% of HCL-variant and 77% of SMZL cases required treatment (P = 0·009). Survival at 5 years was significantly worse in HCL-variant [57% (95% confidence interval 38-73%)] compared with SMZL [84% (71-91%); Hazard Ratio 2·25 (1·20-4·25), P = 0·01]. In HCL-variant, adverse prognostic factors for survival were older age (P = 0·04), anaemia (P = 0·01) and TP 53 mutations (P = 0·02). In SMZL, splenomegaly, anaemia and IGHV genes with >98% homology to the germline predicted the need for treatment; older age, anaemia and IGHV unmutated genes (100% homology) predicted shorter survival. IGHV gene usage had no impact on clinical outcome in either disease. The combination of unfavourable factors allowed patients to be stratified into risk groups with significant differences in survival. Although HCL-variant and SMZL share some features, they have different outcomes, influenced by clinical and biological factors.

Breaking patterns of conflict in Northern Ireland: new perspectives

Central to reaching peace and settlement in Northern Ireland was a sequence of British–Irish intergovernmental discussions and negotiations, dating from the beginning of the 1980s. British and Irish state cooperation and intervention has remained central to the stability of the settlement reached in 1998. The motives of state actors, however, have been unclear, and the role of the state in the political process has been the subject of some scholarly controversy. This paper looks at the types of evidence that can help to resolve such questions. It focuses on the value of elite interviews, arguing that they can constitute an important and irreplaceable body of evidence when used critically, but it also highlights the risks of excessive reliance on this type of source. It goes on to describe a major research project in University College Dublin whose aim was to record the experiences and interpretations of the actors who engaged in British–Irish negotiations over the last four decades. It discusses the resulting elite interviews and witness seminars and the methodological and ethical difficulties encountered. It describes how these were overcome, and outlines the conditions of confidentiality imposed.

Tourette's syndrome and associated disorders: a systematic review

To compile data on Tourette's syndrome (TS), tics and associated disorders. METHODS: A systematic review of the literature was conducted using the 5S levels of organization of healthcare research evidence (systems, summaries, synopses, syntheses, studies), based on the model described by Haynes. The search keywords were Tourette, tics and comorbidity, which were cross-referenced. Studies provided by publishers and articles being processed on July 31, 2013, were also included. RESULTS: Of all studies retrieved during the search, 64 were selected because they analyzed the epidemiology, clinical features and etiopathogenesis of TS and its comorbidities. TS is classified as a hyperkinetic movement disorder, and at least 90% of the patients have neuropsychiatric comorbidities, of which attention deficit hyperactivity and obsessive-compulsive disorders are the most common. The syndrome is clinically heterogeneous and has been associated with a dysfunction of cortico-striatal-thalamic-cortical circuits involving various neurotransmitters. Although its genetic etiology has been widely studied, other factors may be important to understand this syndrome and its associated disorders. CONCLUSIONS: TS is a neurodevelopmental disorder that results from the impact of stress factors on a vulnerable biological substrate during the critical periods of neurodevelopment. The study of TS and its comorbidities may contribute, at different levels, to the understanding of several neuropsychiatric disorders of clinical and therapeutic relevance.

Sesamoids of the metatarsophalangeal joint of the big toe: a sistematic review

Abstract: The first metatarsal sesamoid bones are not always taken into consideration when making a diagnosis, in pathologies that affect the region of the first metatarsal head. This is due to the insufficient knowledge of all the pathologies that can affect the sesamoids and the relative little incidence that they have. With the increment of sports activities, in particular the running, increasingly affects of the symptoms concerning this region are observed. Methods: A literature search was performed in 5 databases (Medline, PubMed, Scopus, Cochrane Library and BUCEA). The terms included in the search were: sesamoids, anatomy, biomechanics, sesamoids review and sesamoids pathology. In the initial search articles with no more than 10 years, only humans and revision texts are considered. Results: 24 articles were selected and include different pathologies with diagnosis using imaging tests and treatments, both conservative and surgical; as well as aspects from the biomechanics of the metatarsal-sesamoid joint. Conclusion: Sesamoids due of his anatomy, topography and function can be involved in a lot of pathologies; with similar signs and symptoms that can confuse the podiatry when he has to make a correct diagnosis or treatment.

Measurement of fusional vergence: protocol for a systematic review

Introduction - No validated protocol exists for the measurement of the prism fusion ranges. Many studies report on how fusional vergence ranges can be measured using different techniques (rotary prism, prism bar, loose prisms and synoptophore) and stimuli, leading to different ranges being reported in the literature. Repeatability of the different methods available and the equivalence between them it is also important. In addition, some studies available do not agree in what order fusional vergence should be measured to provide the essential information on which to base clinical judgements on compensation of deviations. When performing fusional vergence testing the most commonly accepted clinical technique is to first measure negative fusional vergence followed by a measurement of positive fusional vergence to avoid affecting the value of vergence recovery because of excessive stimulation of convergence. Von Noorden recommend using vertical fusion amplitudes in between horizontal amplitudes (base-out, base-up, base-in, and base down) to prevent vergence adaptation. Others place the base of the prism in the direction opposite to that used to measure the deviation to increase the vergence demand. Objectives - The purpose of this review is to assess and compare the accuracy of tests for measurement of fusional vergence. Secondary objectives are to investigate sources of heterogeneity of diagnostic accuracy including: age; variation in method of assessment; study design; study size; type of strabismus (convergent, divergent, vertical, cycle); severity of strabismus (constant/intermittent/latent).

Hybrid mathematical and informational modeling of beam-to-column connections

The analysis of steel and composite frames has traditionally been carried out by idealizing beam-to-column connections as either rigid or pinned. Although some advanced analysis methods have been proposed to account for semi-rigid connections, the performance of these methods strongly depends on the proper modeling of connection behavior. The primary challenge of modeling beam-to-column connections is their inelastic response and continuously varying stiffness, strength, and ductility. In this dissertation, two distinct approaches—mathematical models and informational models—are proposed to account for the complex hysteretic behavior of beam-to-column connections. The performance of the two approaches is examined and is then followed by a discussion of their merits and deficiencies. To capitalize on the merits of both mathematical and informational representations, a new approach, a hybrid modeling framework, is developed and demonstrated through modeling beam-to-column connections. Component-based modeling is a compromise spanning two extremes in the field of mathematical modeling: simplified global models and finite element models. In the component-based modeling of angle connections, the five critical components of excessive deformation are identified. Constitutive relationships of angles, column panel zones, and contact between angles and column flanges, are derived by using only material and geometric properties and theoretical mechanics considerations. Those of slip and bolt hole ovalization are simplified by empirically-suggested mathematical representation and expert opinions. A mathematical model is then assembled as a macro-element by combining rigid bars and springs that represent the constitutive relationship of components. Lastly, the moment-rotation curves of the mathematical models are compared with those of experimental tests. In the case of a top-and-seat angle connection with double web angles, a pinched hysteretic response is predicted quite well by complete mechanical models, which take advantage of only material and geometric properties. On the other hand, to exhibit the highly pinched behavior of a top-and-seat angle connection without web angles, a mathematical model requires components of slip and bolt hole ovalization, which are more amenable to informational modeling. An alternative method is informational modeling, which constitutes a fundamental shift from mathematical equations to data that contain the required information about underlying mechanics. The information is extracted from observed data and stored in neural networks. Two different training data sets, analytically-generated and experimental data, are tested to examine the performance of informational models. Both informational models show acceptable agreement with the moment-rotation curves of the experiments. Adding a degradation parameter improves the informational models when modeling highly pinched hysteretic behavior. However, informational models cannot represent the contribution of individual components and therefore do not provide an insight into the underlying mechanics of components. In this study, a new hybrid modeling framework is proposed. In the hybrid framework, a conventional mathematical model is complemented by the informational methods. The basic premise of the proposed hybrid methodology is that not all features of system response are amenable to mathematical modeling, hence considering informational alternatives. This may be because (i) the underlying theory is not available or not sufficiently developed, or (ii) the existing theory is too complex and therefore not suitable for modeling within building frame analysis. The role of informational methods is to model aspects that the mathematical model leaves out. Autoprogressive algorithm and self-learning simulation extract the missing aspects from a system response. In a hybrid framework, experimental data is an integral part of modeling, rather than being used strictly for validation processes. The potential of the hybrid methodology is illustrated through modeling complex hysteretic behavior of beam-to-column connections. Mechanics-based components of deformation such as angles, flange-plates, and column panel zone, are idealized to a mathematical model by using a complete mechanical approach. Although the mathematical model represents envelope curves in terms of initial stiffness and yielding strength, it is not capable of capturing the pinching effects. Pinching is caused mainly by separation between angles and column flanges as well as slip between angles/flange-plates and beam flanges. These components of deformation are suitable for informational modeling. Finally, the moment-rotation curves of the hybrid models are validated with those of the experimental tests. The comparison shows that the hybrid models are capable of representing the highly pinched hysteretic behavior of beam-to-column connections. In addition, the developed hybrid model is successfully used to predict the behavior of a newly-designed connection.

Tourette's syndrome and associated disorders: a systematic review

To compile data on Tourette's syndrome (TS), tics and associated disorders. METHODS: A systematic review of the literature was conducted using the 5S levels of organization of healthcare research evidence (systems, summaries, synopses, syntheses, studies), based on the model described by Haynes. The search keywords were Tourette, tics and comorbidity, which were cross-referenced. Studies provided by publishers and articles being processed on July 31, 2013, were also included. RESULTS: Of all studies retrieved during the search, 64 were selected because they analyzed the epidemiology, clinical features and etiopathogenesis of TS and its comorbidities. TS is classified as a hyperkinetic movement disorder, and at least 90% of the patients have neuropsychiatric comorbidities, of which attention deficit hyperactivity and obsessive-compulsive disorders are the most common. The syndrome is clinically heterogeneous and has been associated with a dysfunction of cortico-striatal-thalamic-cortical circuits involving various neurotransmitters. Although its genetic etiology has been widely studied, other factors may be important to understand this syndrome and its associated disorders. CONCLUSIONS: TS is a neurodevelopmental disorder that results from the impact of stress factors on a vulnerable biological substrate during the critical periods of neurodevelopment. The study of TS and its comorbidities may contribute, at different levels, to the understanding of several neuropsychiatric disorders of clinical and therapeutic relevance.

Adsorption of aromatic compound by multi-walled carbon nanotube from sea water

It is global concern that soil and water were contaminated with organic substances such as BTEX (benzene) (B), toluene (T) and xylene (x) .The presence of excessive amounts of BTEX in aqueous surroundings may have a greatly adverse impact on water quality and thus endanger public health and welfare. Carbon nanotubes (CNT) have aroused widespread attention as a new type of adsorptions due to their outstanding ability for the removal of various inorganic and organic pollutants from large volume of wastewater. Due to variety of adsorbent and their ability to adsorb pollutant, it is possible to reduce expenses and completely omit pollutant. In this CNT is used as a new adsorbent for removal pollutant such as benzene, toluene, and xylene. The result in the area of adsorbing benzene, toluene, and xylene is as follows: the changes of pH don’t affect the capacity of adsorption and the greatest amount of adsorption occurs in pH. The greatest amount of adsorption occurs when using 0.01gr CNT oxidized. Comparing CNT with CNT oxidized in term of adsorption capacity, it is proved that the adsorption capacity of CNT oxidized is much more than CNT. The result of comparing the percentage of adsorption of mentioned elements (B, X, T) is as follows; the amount of adsorption of xylene is more than toluene and toluene is more than benzene. It should be mentioned that in this research the percentage of adsorption to measure is between to 70-80.

Study of different atmospheric environments associated to storms development in the Madeira Island

The study aims to improve the understanding about different atmospheric environments leading to the development of storms associated with heavy precipitation in Madeira Island. For this purpose, four main goals have been considered: 1) To document the synoptic and mesoscale environments associated with heavy precipitation. 2) To characterize surface precipitation patterns that affected the island during some periods of significant accumulated precipitation using numerical modelling. 3) To study the relationship between surface precipitation patterns and mesoscale environments. 4) To highlight how the PhD findings obtained in the first three goals can be translated into an operational forecast context. Concerning the large scale environment, precipitation over the island was favoured by weather systems (e.g, mesoscale convective systems and low pressure systems), as well as by the meridional transport of high amount of moisture from a structure denominated as “Atmospheric River”. The tropical origin of this moisture is underscored, however, their impact on the precipitation in Madeira was not so high during the 10 winter seasons [2002 – 2012] studied. The main factor triggering heavy precipitation events over the island is related to the local orography. The steep terrain favours orographically-induced stationary precipitation over the highlands, although maximum of precipitation at coastal region may be produced by localized blocking effect. These orographic precipitating systems presented different structures, associated with shallow and deep convection. Essentially, the study shows that the combination of airflow dynamics, moist content, and orography is the major mechanism that produces precipitation over the island. These factors together with the event duration act to define the regions of excessive precipitation. Finally, the study highlights two useful points for the operational sector, regarding the meridional water vapour transport and local effects causing significant precipitation over the Island; RESUMO: O estudo procura melhorar o entendimento sobre os diferentes ambientes atmosféricos que favorecem o desenvolvimento de tempestades associadas com precipitação intensa na ilha da Madeira. Nesse sentido foram definidos quatro objetivos: 1) Documentar os ambientes sinópticos e de mesoescala associados com precipitação intensa; 2) Caracterizar padrões de precipitação na superfície, em eventos de elevada precipitação acumulada, utilizando modelação numérica; 3) Estudar as relações entre os padrões de precipitação e ambientes de mesoescala; 4) Mostrar como tais resultados podem ser utilizados num contexto operacional de previsão do tempo. Em relação a ambientes de larga escala, verificou-se que a ocorrência de eventos de precipitação intensa sobre a ilha foi favorecida por sistemas meteorológicos, assim como pelo transporte meridional de humidade por meio de estruturas atualmente denominadas Rios atmosféricos. Neste último caso é de destacar a origem tropical de humidade, no entanto, o seu impacto na precipitação sobre a Madeira durante os 10 invernos estudados [2002-2012] não foi tão elevada. O principal fator que favorece os eventos de precipitação intensa está relacionado com a orografia local. O terreno complexo da ilha favorece a ocorrência de precipitação estacionária induzida orograficamente sobre as terras mais altas, embora a precipitação nas zonas costeiras possa ser produzida por um efeito localizado de bloqueio. Estes sistemas orográficos precipitantes apresentaram diferentes estruturas, associados a convecção pouco profunda e profunda. O estudo mostra que a combinação entre as características do escoamento, a quantidade de humidade, e a orografia são os condimentos essenciais para o desenvolvimento da precipitação sobre a ilha, atuando de maneira a definir as regiões de precipitação excessiva. Por fim, o estudo destaca dois pontos que podem ser úteis na previsão do tempo operacional, ligados a larga escala e aos efeitos locais, os quais podem levar ao desenvolvimento de tempestades e precipitação intensa sobre a ilha.

Factor structure of the General Health Questionnaire-28 (GHQ-28) from infertile women attending the Yazd Research and Clinical Center for Infertility

Background: Nowadays, infertility problems have become a social concern, and are associated with multiple psychological and social problems. Also, it affects the interpersonal communication between the individual, familial, and social characteristics. Since women are exposed to stressors of physical, mental, social factors, and treatment of infertility, providing a psychometric screening tool is necessary for disorders of this group. Objective: The aim of this study was to determine the factor structure of the general health questionnaire-28 to discover mental disorders in infertile women. Materials and Methods: In this study, 220 infertile women undergoing treatment of infertility were selected from the Yazd Research and Clinical Center for Infertility with convenience sampling in 2011. After completing the general health questionnaire by the project manager, validity and, reliability of the questionnaire were calculated by confirmatory factor structure and Cronbach's alpha, respectively. Results: Four factors, including anxiety and insomnia, social dysfunction, depression, and physical symptoms were extracted from the factor structure. 50.12% of the total variance was explained by four factors. The reliability coefficient of the questionnaire was obtained 0.90. Conclusion: Analysis of the factor structure and reliability of General Health Questionnaire-28 showed that it is suitable as a screening instrument for assessing general health of infertile women.

Comparing Atlantic and Mediterranean populations of the velvet belly lanternshark, Etmopterus spinax, with comments on the efficiency of density-dependent compensatory mechanisms

Etmopterus spinax is a small-sized deep-water lantern shark that occurs in the Eastern Atlantic and the Mediterranean. Differences in depth distribution, densities, size at maturity and fecundity were compared between a population that has suffered high levels of fishing mortality during the last decades (Southern Portugal in the northeast Atlantic) and a population where low fishing pressure below 500 m occurs at present or has occurred in the last decades (Northern Alboran Sea in the western Mediterranean). The density of this species, as derived by experimental bottom trawl survey, off the coast of Southern Portugal, is substantially lower than in the Northern Alboran Sea throughout the entire depth range. The Atlantic population is maturing at smaller sizes than the Mediterranean population and has a lower mean fecundity. Specifically, sizes at maturity for Southern Portugal and the Northern Alboran Sea were, respectively, 25.39 and 28.31 cm TL for males and 30.86 and 34.18 cm TL for females, while mean fecundities for Southern Portugal and the Northern Alboran Sea were, respectively, 9.94 and 11.06 oocytes per mature female. This work demonstrated the possible presence of density-dependent mechanisms in the Southern Portuguese population of E. spinax that has lowered the size at maturity as a possible result of excessive fishing mortality. However, given that this is an aplacentary viviparous shark, where fecundity is dependent on female size, this compensatory mechanism seems to have a limited efficiency.

Infección por virus sincitial respiratorio y su relación con valores de IGG en niños críticos

Antecedente: La infección por el virus sincitial respiratorio (VSR) representa una elevada morbimortalidad, y en algunos casos necesidad de manejo en unidades de cuidado intensivo pediátrico (UCIP). La respuesta inmunológica influye de manera directa en la expresión de la severidad y pronóstico de los pacientes con infección respiratoria. Metodología: Estudio de una cohorte retrospectiva de pacientes con infección respiratoria grave secundaria a VSR, sin historia de inmunodeficiencia, atendidos en la UCIP del Hospital Universitario Clínica San Rafael. Se realizó análisis descriptivoglobaly de acuerdo a la categorización de las prueba de IgG. Resultados: De 188 pacientes que ingresaron a la UCIP, 13% presentaron infección por VSR (24), con una edad promedio de 7,3 (DE=3,6) meses. Pertenecían al sexo masculino79,83%. Se encontró que 12,5% tenían un valor de IgGbajo para su edad, 58,33% tenían valores en límite inferior y el 29,17% dentro de rangos normales para su edad. En los pacientes con IgG baja, fue mayor la presentación de choque séptico que no responde a líquidos (100 vs 92 vs 86%), la mediana de días de ventilación mecánica fue mayor (8 vs 6 vs 5 respectivamente), así como la mortalidad (67 vs 7,1 vs 0%). Conclusión: Nuestra serie encontró que aquellos pacientes con niveles bajos o valores en el límite inferior de IgG sérica tuvieron mayor compromiso sistémico, mayor duración de ventilación mecánica y mayor mortalidad. Se necesitan estudios prospectivos que relaciones niveles bajos de IgG con severidad y pronostico en estos pacientes con infección grave por VSR.

A-REIT seasoned equity offerings : determinants and market reaction

The paper examines the decision by Australian Real Estate Trusts (A-REITs) to issue seasoned equity offerings from 2000 - 2008 and stock market reaction to the offerings using panel data and event study methodologies, respectively. The global financial crisis has resulted in freezing of the Australian bond markets, with several A-REITs left with seasoned equity issuance and asset sales as the only viable modes of raising additional capital. The findings review that leverage and operating risk are negative significant determinants of seasoned equity offerings; profitability and growth opportunities are positive significant determinants. Of the structure and type of properties held by the A-REIT, only stapled management structure and international operations are significant determinants. Type of properties held by A-REITs show inconsistent results. Similar to previous studies of seasoned equity offerings, we find a significant negative abnormal return associated with their announcement and no evidence of excessive leakage of information. Cross-sectional regressions show that the issued amount raised and leverage are significant factors affecting abnormal returns.